ANDREA E KIRK PHD
NPI 1306601158
Psychologist - Clinical in Sebastopol, CA

Q: What is Andrea E Kirk Phd's NPI number?

The NPI number for Andrea E Kirk Phd is 1306601158. It was assigned to this organization in the NPPES registry on February 20, 2024.

Q: What is Andrea E Kirk Phd's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Andrea E Kirk Phd was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 20, 2024

309 S MAIN ST, SEBASTOPOL, CA 95472(707) 939-5475 Get Directions Write a Review

NPPES record last updated: February 20, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Andrea E Kirk Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREA E KIRK PHD (NPI 1306601158) is a healthcare organization registered as a clinical in Sebastopol, California and active in the NPI registry since February 2024. The organization lists Andrea Kirk, Owner, as its authorized official.

NPPES Registry Identity

NPI1306601158

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameANDREA E KIRK PHD

Location Address309 S MAIN STSebastopol, CA 95472-4208

Mailing Address309 S Main StSebastopol, CA 95472-4208 · (707) 939-5475

Phone(707) 939-5475

Organization SubpartNo

Authorized OfficialAndrea KirkOwner · (707) 393-5475

Enumeration DateFebruary 20, 2024

NPPES CertifiedFebruary 20, 2024

✔ NPI 1306601158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

309 S MAIN ST, Sebastopol, CA 95472

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrea E Kirk Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Andrea E Kirk Phd, which bills Medicare for the services this clinician delivers.

Clinician (1)

Andrea Kirk, PH. D

Clinical Psychologist

NPI 1760939318

309 S MAIN ST
Sebastopol, CA 95472

(707) 939-5475

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrea E Kirk Phd's NPI number?

The NPI number for Andrea E Kirk Phd is 1306601158. It was assigned to this organization in the NPPES registry on February 20, 2024.

Where is Andrea E Kirk Phd located?

Andrea E Kirk Phd is located at 309 S Main St, Sebastopol, CA 95472. The listed phone number is (707) 939-5475.

What is Andrea E Kirk Phd's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Andrea E Kirk Phd enrolled in Medicare?

Yes. Andrea E Kirk Phd is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Andrea E Kirk Phd?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Andrea E Kirk Phd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Andrea E Kirk Phd was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.